title: Endoscopic treatment of biliary fistulas developing after liver resections.
abstract: Bile leaks are a major cause of mortality and morbidity after liver resections. We prospectively evaluated the safety and efficacy of endoscopic treatment of biliary fistulas developing after liver resections in 15 patients. Fistulas developed after extended right hepatectomy in 4, extended left hepatectomy in 8, and segmentectomy in 3 patients. Median time interval between surgery and endoscopic intervention was 10 days (range, 7 to 35 d). Endoscopic sphincterotomy followed by a nasobiliary drain insertion was the initial treatment. If the fistula persisted after 2 weeks, nasobiliary drain was replaced by a plastic stent. The effect of output (low in 10 and high in 5 patients) and the origin of fistula (stump in 10 and resection surface of the liver in 5 patients) on the time for closure were evaluated. Bile leakage ceased by only nasobiliary drainage catheter placement in 11 patients (73.3%). Plastic stents were inserted in 4 patients. There was a significant correlation between the output of bile leakage and the time needed for fistula closure. Endoscopic treatment methods are effective in patients with bile leaks due to liver resections.
authors.affiliation: Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Sihhiye Ankara, Türkiye.
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.forename: Selçuk
authors.initials: S
authors.lastname: Dişibeyaz
authors.forename: Bülent
authors.initials: B
authors.lastname: Ödemiş
authors.forename: Öykü
authors.initials: Ö
authors.lastname: Tayfur
authors.forename: Aydin S
authors.initials: AS
authors.lastname: Köksal
authors.forename: Semih
authors.initials: S
authors.lastname: Sezer
authors.forename: Nurgül
authors.initials: N
authors.lastname: Şaşmaz
authors.forename: Burhan
authors.initials: B
authors.lastname: Şahin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000209:etiology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D004322:Drainage; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D061646:Operative Time; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D015607:Stents; D055815:Young Adult